Minimizing Your Skin Cancer Risk

Enjoy the season, but beware the sun.

By Karen A. Jamrog

Summer is here. Planning to hit the beach or lake? Maybe you prefer to hike, bike, golf or garden. The sunny, warm season in New Hampshire is brief but glorious, offering an abundance of recreational pursuits. Enjoy it while you can. Just don’t forget the sunscreen.

Ah, yes, the dreaded “s” word that’s been known to send young children into hiding. Adults are not necessarily fans, either. It’s messy, it’s expensive, and it takes time to apply. But sunscreen should be as integral to summer as shorts and flip flops. In fact, sunscreen should be a part of your life every day, year round, because even though it’s not fun to deal with while frolicking in the tropics or preparing to schuss down a white-blanketed slope up north, skipping sunscreen increases your risk of developing skin cancer—the most common form of cancer in the United States, which strikes more than two million people annually, according to The Skin Cancer Foundation.

"There’s no such thing as a healthy tan. It’s an oxymoron."

There are various types of skin cancer. Basal cell is the most frequently diagnosed and least aggressive form of skin cancer, followed by squamous cell, which has the potential to metastasize or spread throughout the body. Melanoma is the least common form of skin cancer but the most dangerous. Skin cancer is treatable if recognized and treated early.

Keep skin healthy

In addition to using sunscreen, a sure-fire way to minimize your risk of skin cancer is to steer clear of tanning beds. Although tans fade, the hazardous effects of tanning beds’ deeply penetrating UVA light last forever. In fact, “occasional use of tanning beds increases one’s risk of melanoma by 50 to 75 percent over the course of a lifetime,” says Robert Gordon, MD, a dermatologist at Merrimack Medical Center and Southern NH Medical Center.

FYI
Beauty in a bottle?

If you routinely spend gobs of money on creams and lotions that promise to bring youthful-looking skin, you might want to bypass the cosmetics counter and redirect your funds to purchase bottles of sunscreen. A whopping 90 percent of skin changes that we typically chalk up to aging actually comes from sun damage, according to The Skin Cancer Foundation. So slather up every day, year-round, since the sun’s rays penetrate clouds, says Robert Gordon, MD, a dermatologist at Merrimack Medical Center and Southern NH Medical Center.

So, if you’re thinking about getting some base color — with or without the aid of a tanning bed — before heading off to Aruba or some other tropical locale, don’t do it, experts say. Except for rare cases in which patients’ sun tolerance is so low that they are likely to break out in a rash or end up with sun poisoning upon hitting the beach, developing a base tan for protective purposes is a bad idea, says Robert J. Willer, MD, a dermatologist at Dartmouth-Hitchcock Manchester. And even in those low-tolerance cases, a base tan will not provide protection against skin cancer, he notes.

But it’s a popular misconception. “People think, ‘I’ll get a base, then I won’t burn. That way I can get a healthy tan,’” says Gordon. “But if you have a great tan — let’s say you get really dark—that gives you a sun protection factor of four, which is totally inadequate.” Besides, he says, “There’s no such thing as a healthy tan. It’s an oxymoron.” His advice? “Go on vacation and have a great time, but use decent sunblock and don’t go with the goal of getting a tan.”

Also keep in mind that not all sunscreens are created equal. For routine use, most of us should use a sunscreen that offers a sun protection factor, or SPF, of 45. Don’t bother with anything below a 30, Willer says. A higher SPF might be warranted under some conditions, such as for sun-intensive outings on the golf course or beach or for everyday use by individuals who have a history of melanoma.

We will all have to rethink our sunscreen strategy once impending FDA rules regarding sunscreen labeling are implemented, but in the meantime pay attention to the SPF you choose, and be sure to buy a “broad spectrum” product for protection against UVA as well as UVB rays since both can cause cancer, Willer says. And when you apply sunscreen, don’t be stingy. It takes one to one-and-a-half ounces to properly cover the whole body, he says, “so one bottle of sunscreen would be used up in one day for a family of four if they’re out in the sun very long.” Use it daily, even if it’s cloudy. “UVA light goes through clouds and window glass and is around in the winter as well as in the summer, so if you want coverage, you should use it every day,” Willer says.

For the naysayers

Some individuals argue against vigorous sun protection, pointing to vitamin D deficiency in much of the population and questioning the safety of the chemicals contained in sunscreen. It’s true that while you’re loading up on sunscreen at the store, you might want to grab some vitamin D supplements since individuals who live in New England and have limited sun exposure are often deficient in vitamin D. But using the sun to get vitamin D — the sun does stimulate vitamin D production in people — is playing with fire. Stick with supplements instead, Willer says, and try to include vitamin D-rich food in your diet.

As for sunscreen safety, whether chemicals found in sunscreens are harmful is “highly disputed and debated,” Willer says, but the idea “has been pretty much debunked.” Those who remain skeptical can buy sunblock that contains titanium dioxide and zinc oxide to provide a layer of curtain-like protection that will not be absorbed into the skin, he says, or they can opt for sun-protective clothing with built-in SPF as long as remaining exposed patches of skin are shielded one way or another from the sun’s rays.

Check Yourself Out

People with fair skin are at increased risk of skin cancer, but individuals of any race or skin color can get it, says Robert J. Willer, MD, a dermatologist at Dartmouth-Hitchcock Manchester.

Perform a monthly skin check to catch any skin abnormalities early, and enlist help with hard-to-view areas such as the back. Be sure to examine every area that has ever been exposed to the sun or to tanning bed rays. If you spot anything suspicious, don’t delay in making an appointment with your doctor or a dermatologist, Willer says.